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Cardiac Surgery

Cardiac surgery refers to surgery involving the heart and great vessels surrounding the heart. Coronary revascularization (more commonly known as bypass surgery), Valve replacements (or reconstruction, if appropriate), and pacemaker implants are just a few of the many procedures commonly grouped under the field of cardiovascular surgery.

Arrhythmia Surgery

The MAZE Procedure is performed by cardiothoracic surgeons on the left and right atrium for the treatment of atrial fibrillation. Atrial fibrillation is an abnormality of the electrical system of the heart. Normally, the heartbeat is triggered by an electrical impulse which starts in the Sinoatrial (SA) node. This structure resides in the right atrium and is the normal “pacemaker” of the heart. The electrical signal to contract starts in the SA node and normally moves evenly across the atrium, triggering it to contract all at once. The impulse then travels across the atrioventricular ( AV ) node and triggers the ventricles (the main pumping chambers of the heart) to contract. This is called sinus rhythm. Atrial fibrillation occurs when this electrical impulse no longer travels from SA node to the AV node in the normal manner. Instead of the impulse traveling evenly across the atrium straight from the SA node to the AV node, the impulse is “side-tracked” such that the atrium is no longer triggered evenly and in synchrony, but is triggered one small region at a time. The atrium no longer contracts in a coordinated manner, but instead it fibrillates irregularly. The electrical signal to ventricle through the AV node is therefore irregular and hence the heartbeat is irregular.

Coronary Artery Bypass Grafting (CABG)

CABG surgery is advised for selected groups of patients with significant narrowings and blockages of the heart arteries (coronary artery disease). CABG surgery creates new routes around narrowed and blocked arteries, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscle. Watch this video for more information.

Mitral Valve Repair

Mitral valve repair is an open heart procedure performed by cardiothoracic surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the “inflow valve” for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, and into the heart through the mitral valve. When it opens, the mitral valve allows blood to flow into the heart’s main pumping chamber called the left ventricle. It then closes to keep blood from leaking back into the lungs when the ventricle contracts (squeezes) to push blood out to the body.

Mitral Valve Replacement

Mitral valve repair is an open heart procedure performed by cardiothoracic surgeons to treat stenosis (narrowing) or regurgitation (leakage) of the mitral valve. The mitral valve is the “inflow valve” for the left side of the heart. Blood flows from the lungs, where it picks up oxygen, and into the heart through the mitral valve. When it opens, the mitral valve allows blood to flow into the heart’s main pumping chamber called the left ventricle. It then closes to keep blood from leaking back into the lungs when the ventricle contracts (squeezes) to push blood out to the body. It has two flaps, or leaflets.

Off-Pump Coronary Artery Bypass Grafting (OPCAB)

OPCAB is a coronary artery bypass graft (CABG) done without putting the patient on the heart-lung machine. Off-pump CABG permits surgery on multiple vessels within the heart by mechanically stabilizing it. Off-pump surgery is minimally invasive, as compared to surgery on the heart-lung machine. The potential benefits include shorter hospital stay, less bleeding, less chance for infection, less risk of irregular heartbeats (arrhythmia), less trauma, shorter recovery time, and greater cost effectiveness.

Ross Procedure

The Ross operation is an open heart procedure performed with the assistance of the heart-lung machine. After the patient is hooked up onto the machine and the heart stopped, the pulmonary valve is harvested. The diseased aortic valve is then excised, and the harvested pulmonary valve is implanted in a manner very similar to the aortic homograft implantation. The right ventricle outflow tract (from which the pulmonary valve was removed) is now reconstructed using a biologic tissue valve or human homograft valve. If the disease is more extensive and involves a part of the aortic root too, the operation can be modified to excise the damaged portion of the aortic valve and use the pulmonary valve and artery to replace it.

Since the Ross procedure involves removing the native pulmonary valve, a replacement must be put back in place. Choices include 1) using a bioprosthetic valve, 2) an aortic homograft (the aortic valve harvested from a human cadaver), or 3) a pulmonary homograft. The pulmonary homograft is often preferred because it is nearly identical to the valve that it replaces.

Download our Ross Procedure Information Packet

Read more information at www.therosscommunity.org

Transmyocardial Laser Revascularization (TMR / TMLR)

TMR is a new treatment aimed at improving blood flow to areas of the heart that were not treated by angioplasty or surgery. A specialized laser is used to create small channels in the heart muscle, improving blood flow in the heart. TMR is a surgical procedure. The procedure is performed through a small left chest incision or through a midline incision. TMR can also be performed using a robotic approach. Frequently, TMR is performed with coronary artery bypass surgery, but occasionally it is performed independently.

Download our TMR Information Packet.

Read more information at www.cardiogenesis.com